“We found that glutamate release in the brain was impaired in mice lacking low-density lipoprotein receptor–related protein 4 (Lrp4), a protein that is critical for neuromuscular junction formation.”

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Could this relate to POTS which improves with mestinon? or chronic fatigue of so many conditions (CRPS, fibromyalgia, Lyme Disease)?

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“In the neuromuscular juncture, Mei’s lab found several years back that LRP4 on the muscle cell surface is a receptor for agrin, a protein that motor neurons release to direct construction of the nerve-muscle juncture. His lab later identified antibodies to LRP4 and agrin as new causes of myasthenia gravis. The new research indicates that release of ATP by astrocytes is also regulated by agrin signaling.”

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…”When you take LRP4 out of astrocytes, ATP levels released by those astrocytes go super high, which suppresses glutamate transmission,” Mei said.

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“Now it’s clear that glial cells, like astrocytes, have a role in neurodevelopment and longer-term in regulating communication between two neurons.”